To: Sonoma County Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Tina Rivera, 707-565-4774
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Clinical Staffing Agreements
End
Recommended Action:
Recommended action
A) Authorize the Director of Health services, or designee, to execute an agreement with Maxim Healthcare Staffing Services to provide clinical staffing services through June 30, 2026, in an amount not-to-exceed $575,200 per fiscal year.
B) Authorize the Director of Health services, or designee, to execute an agreement with Cynet Health, Inc. to provide clinical staffing services through June 30, 2026, in an amount not-to-exceed $150,000 per fiscal year.
C) Authorize the Director of Health services, or designee, to execute an agreement with LanceSoft, Inc. to provide clinical staffing services through June 30, 2026, in an amount not-to-exceed $150,000 per fiscal year.
end
Executive Summary:
The Sonoma County Department of Health Services (hereinafter, “DHS” or “the Department") has determined a need to engage clinical staffing agencies to provide immediate and short-term clinical staff in two Public Health Programs: 1) Health Care Coordination - Medical Therapy Program, and 2) Special Clinical Services - Juvenile Hall. Both programs currently have budgeted staff positions which their program managers have been unable to fill for many months, some for over a year. Based on the results of a request for proposal (RFP) solicitation completed earlier this year, the Department is requesting authority to enter into agreements with three clinical staffing services providers for services through June 2026 in a total not-to-exceed amount of $875,200 per fiscal year.
DHS is requesting authorization to award multiple agreements to be used to cover urgent staffing needs in the two Public Health programs mentioned above on an as-needed basis. These agreements will provide maximum flexibility allowing DHS to augment its staff on an as-needed basis while it continues to actively recruit and fill vacant positions. Each agreement with a clinical staffing agency is written for a not-to-exceed amount covering the maximum estimated hours needed to support each program. Total expenditures for the three clinical staffing agreements will not exceed available appropriations.
Discussion:
The Department determined a need to engage clinical staffing agencies to provide immediate and short-term clinical staff in two Public Health Programs: 1) Health Care Coordination - Medical Therapy Program (MTP) and 2) Special Clinical Services - Juvenile Hall. Both programs currently have budgeted staff positions which their program managers have been unable to fill for many months, some over a year. The County of Sonoma, like other organizations locally and across the nation, is experiencing significant difficulty recruiting for several job classifications resulting in higher-than-normal position vacancy rates and/or small candidate pools. This is reflective of the tight labor market for health professionals throughout the country.
The County has taken measures to rectify this including implementing a Hiring Incentive Pilot Program approved by the Board on April 18, 2023 and approving increased staffing in DHS and Human Resources to increase recruitment efforts and provide sufficient staffing to streamline hiring, selection, and on-boarding processes within DHS. Utilizing clinical staffing services is necessary to fill existing program gaps in essential services to the community in MTP for Occupational Therapists and Physical Therapists and Juvenile Hall for Staff Nurses. The expectation is that between these three vendors they will provide some or all of the types of staffing needed to support operational needs on an as-needed basis.
The Department executed a request for proposals (RFP) process in late 2022. The RFP was posted in the Sonoma County Supplier Portal on November 1, 2022, with proposals due on December 2, 2022.
The Department provided the Sonoma County Public Infrastructure Purchasing Division with a vendor list containing 21 agencies. In addition to those identified on the vendor list, the RFP was distributed to all individuals/entities registered in the Sonoma County Portal and Purchasing’s Govdelivery Notification System (approximately 730 individuals/entities).
Public Health Positions included in this RFP:
• Certified Nursing Assistant
• Licensed Vocational Nurse
• Nurse Practitioner/ Physician’s Assistant
• Registered Nurse II
• Physical Therapist
• Occupational Therapist
Twenty-eight submissions were received. Two were duplicate submissions and two did not include the narrative proposal, making them ineligible. The remaining 24 proposals were reviewed by the committee and scored based on the following criteria:
a. Existing capacity for and experience with providing similar services
b. Ability to provide appropriate staff in a timely manner
c. Cost of providing services
d. Locality of the proposer
e. Living Wage compliance
The evaluation committee recommended award to the following top proposers:
• Maxim Healthcare Staffing Services
• Cynet Health
• LanceSoft
After the review process, Notice of Intent to Award letters were mailed to the selected vendors on July 5, 2023 followed by the contract negotiation process resulting in the attached agreements. The recommendation to award multiple contracts is necessary as a single agency is generally not able to provide for all clinical staffing needs. The Department is requesting authorization to award multiple agreements to be used to cover urgent Public Health staffing needs on an as-needed basis.
Strategic Plan:
This item directly supports the County’s Five-year Strategic Plan and is aligned with the following pillar, goal, and objective.
Pillar: Healthy and Safe Communities
Goal: Goal 1: Expand integrated system of care to address gaps in services to the County’s most vulnerable.
Objective: Objective 2: Identify gaps in the Safety Net system of services and identify areas where departments can address those gaps directly, and seek guidance from the Board when additional resources and/or policy direction is needed.
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
None
Fiscal Summary
|
Expenditures |
FY23-24 Adopted |
FY24-25 Projected |
FY25-26 Projected |
|
Budgeted Expenses |
$875,200 |
$875,200 |
$875,200 |
|
Additional Appropriation Requested |
|
|
|
|
Total Expenditures |
$875,200 |
$875,200 |
$875,200 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$875,200 |
$875,200 |
$875,200 |
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
Contingencies |
|
|
|
|
Total Sources |
$875,200 |
$875,200 |
$875,200 |
Narrative Explanation of Fiscal Impacts:
No additional appropriations are required for staffing expenses related to the vacant permanent staff as appropriations will be utilized from staff salary savings. Medical Therapy Program is funded 50% from State of California Medical Therapy Program allocations; 25% from County Human Services Department; and 25% from 91 Realignment. Juvenile Hall program is 100% reimbursed by the Juvenile Probation Department.
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Narrative Explanation of Staffing Impacts (If Required):
N/A
Attachments:
Attachment 1 - Agreement with Maxim Healthcare Staffing Services
Attachment 2 - Agreement with Cynet Health, Inc.
Attachment 3 - Agreement with LanceSoft, Inc.
Related Items “On File” with the Clerk of the Board:
N/A